Heel Pain

Inside Your Heel

Your heel is the back part of your foot. A band of tissue called the plantar fascia connects the heel bone to the bones in the ball of your foot. Nerves run from the heel up the inside of your ankle and into your leg. These nerves send pain messages from your foot to your brain telling you when you have heel pain.

When Your Heel Hurts

When you feel pain in the bottom of your heel, the plantar fascia is most likely inflamed. Overuse or excess body weight can cause the tissue to tear or pull away from the bone. The tissue then becomes inflamed and painful. Sometimes the inflamed plantar fascia also irritates a nerve, causing more pain.

What Causes Heel Pain?

Wearing shoes with poor cushioning can irritate the tissue in your heel (plantar fascia). Being overweight or standing for long periods can also irritate the tissue. Running, walking, tennis, and other sports that put stress on the heels can cause tiny tears in the tissue. If your lower leg muscles are tight, this is more likely to occur.

Symptoms

You may feel pain on the bottom or on the inside edge of your heel. The pain may be sharp when you get out of bed or when standing up after sitting for a while. You may feel a dull ache in your heel after you've been standing for a long time on a hard surface. Running can also cause a dull ache. If a nerve is irritated, you may feel burning or a shooting pain in your heel.

Diagnosis and Treatment

Your doctor will check your foot and ask about your pain. Be sure to him/her exactly where your heel hurts. To treat your pain, you may need to make changes in what you do and your shoes that you wear. You may also need to exercise to stretch the tissue. The tissue can take up to 6 months or more to fully heal. In some cases, your doctor may suggest surgery to release the plantar fascia.

Activities

To give the tissue time to heal, avoid doing things that strain it and cause pain. This may include standing or walking for long periods and running.

Foot Stretch

Lie on your back with your legs straight

Stretch your toes toward you. Or put a towel around the ball of your foot and pull it toward you

Hold for 10 to 20 seconds, relax

Repeat 10 times

Heel Stretch

Stand with the ball of the painful foot on the edge of a step. Hold on to the railing

Slowly drop the heel down until you feel a stretch in the back of your calf

Hold for 30 seconds. Repeat 4 times a day

Shoes

Buy shoes with good cushioning in the soles and heels. Replace athletic shoes before the cushioning in the heels wear out.

Shoe Inserts

To add cushioning to the heel, put a heel cup or pad in your shoe. Or your doctor may prescribe a special shoe insert.

Contrast Baths

To reduce the inflammation, soak the foot in warm water for 30 seconds. Then soak it in cool water for 30 seconds. Go back and forth for 5 minutes. Do this 3 to 4 times a day. Or you can hold an ice pack on the heel for up to 5 minutes, 3 to 4 times a day.

Medication

Your doctor may suggest on oral anti-inflammatory medicine, such as ibuprofen, to reduce the inflammation. If you still have heel pain after changing your shoes and doing heel stretches for several months, your doctor may inject cortisone into the tissue.

Preventing Future Problems

To prevent future heel pain, wear shoes with well-cushioned heels. And do exercises, such as the one below, to stretch the plantar fascia and the muscles in the lower leg.

Calf Stretch

Stand with one foot an arm's length away from a tree or wall. Place the other foot about 12″ behind. Put both hands on the tree or wall

Keeping both heels on the ground, bend the knee on the leg closest to the tree or wall. Lean forward, keeping the back leg straight. Hold the stretch for 15 to 20 seconds

Now bend both knees. Hold for 15 to 20 seconds. Then relax

Repeat 10 times. Then switch

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